John Seddon of Vanguard Consulting wrote in his latest newsletter –
“I regularly shout at the radio when I listen to commentators talk about health and care systems. They trot out the Whitehall narrative: People are getting older, demand for services is growing, the status quo is not sustainable; we have to decide what to stop doing and who will pay.
The NHS Sustainability Transformation Plans (should be called doing-the-wrong-thing-righter plans) being cooked up around the country – which ministers want kept secret – are based on the notion that efficiency is as tight as a drum. It is not. The NHS is grossly ineffective and, consequently, grossly inefficient. Demand isn’t rising, it is stable. Unlike Whitehall, we’ve studied it.
What is rising, inexorably, is failure demand; caused, as ever, by industrialisation: standardisation (‘protocols’), specialisation, activity management, targets and an absence of continuity in the relationship between patients and the service.
This way of managing amounts to tampering with the system, making performance worse, and the worse it becomes, the more the leaders bully their staff. Forget protection of whistle-blowers; anyone who raises concerns about the system will be vilified.